The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: Summary of main findings and risk factors

Anaesthesia

Volumn 69, Issue 10, 2014, Pages 1089-1101

  Pandit, J J ^a   Andrade, J ^b   Bogod, D G ^c   Hitchman, J M ^d   Jonker, W R ^e   Lucas, N ^f   Mackay, J H ^g   Nimmo, A F ^h   O'Connor, K ⁱ   O'Sullivan, E P ^j   Paul, R G ^k   Palmer, J H M ^l   Plaat, F ^m   Radcliffe, J J ⁿ   Sury, M R J ^o   Torevell, H E ^p   Wang, M ^q   Hainsworth, J ^r   Cook, T M ^s  

^a OXFORD UNIVERSITY HOSPITALS NHS FOUNDATION TRUST   (United Kingdom)

^b UNIVERSITY OF PLYMOUTH   (United Kingdom)

^c NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST   (United Kingdom)

^d ROYAL COLLEGE OF ANAESTHETISTS   (United Kingdom)

^e SLIGO UNIVERSITY HOSPITAL   (Ireland)

^f NORTHWICK PARK HOSPITAL   (United Kingdom)

^g PAPWORTH HOSPITAL   (United Kingdom)

^h ROYAL INFIRMARY OF EDINBURGH   (United Kingdom)

ⁱ Bristol School of Anaesthesia   (United Kingdom)

^j ST JAMES S HOSPITAL   (Ireland)

^k ROYAL BROMPTON HOSPITAL   (United Kingdom)

^l HOPE HOSPITAL   (United Kingdom)

^m IMPERIAL COLLEGE HEALTHCARE NHS TRUST   (United Kingdom)

ⁿ NATIONAL HOSPITAL FOR NEUROLOGY AND NEUROSURGERY   (United Kingdom)

^o Department of Anaesthesia Great Ormond Street Hospital NHS Foundation Trust ^*  (United Kingdom)

^p BRADFORD TEACHING HOSPITALS NHS FOUNDATION TRUST   (United Kingdom)

^q UNIVERSITY OF LEICESTER   (United Kingdom)

^r LEICESTERSHIRE PARTNERSHIP NHS TRUST   (United Kingdom)

^s ROYAL UNITED HOSPITAL   (United Kingdom)

more..

Author keywords

[No Author keywords available]

Indexed keywords

DESFLURANE; ETOMIDATE; ISOFLURANE; KETAMINE; MIDAZOLAM; NITROUS OXIDE; PROPOFOL; SEVOFLURANE; THIOPENTAL;

ACCIDENTAL AWARENESS; ADULT; AGE; ANESTHESIA INDUCTION; ANESTHESIA LEVEL; ANESTHESIST; ARTICLE; AWARENESS; BODY WEIGHT; CESAREAN SECTION; ELECTROENCEPHALOGRAM; EMERGENCY SURGERY; EYE SURGERY; FEMALE; GENDER; GENERAL ANESTHESIA; GENERAL SURGERY; HEART SURGERY; HUMAN; INTENSIVE CARE; INTRAVENOUS ANESTHESIA; MAJOR CLINICAL STUDY; MALE; MEDICATION ERROR; MOTOR PERFORMANCE; NEUROMUSCULAR BLOCKING; NEUROSURGERY; OBESITY; OBSTETRIC ANESTHESIA; OBSTETRIC OPERATION; OPERATING ROOM; ORTHOPEDIC SURGERY; PARALYSIS; PATIENT TRANSPORT; PEDIATRIC ANESTHESIA; PERSONAL EXPERIENCE; PLASTIC SURGERY; RACE; RESPIRATION CONTROL; RISK FACTOR; SEDATION; SYRINGE; THORAX SURGERY; UNDERWEIGHT; VASCULAR SURGERY; X RAY; INCIDENCE; INTRAOPERATIVE AWARENESS; MEDICAL AUDIT;

ANESTHESIA, GENERAL; HUMANS; INCIDENCE; INTRAOPERATIVE AWARENESS; MEDICAL AUDIT; RISK FACTORS;

EID: 84908025613     PISSN: 00032409     EISSN: 13652044     Source Type: Journal    
DOI: 10.1111/anae.12826     Document Type: Article

References (46)

1. Cook TM, Pandit JJ. NAP5: accidental awareness during general anaesthesia. Bulletin of the Royal College of Anaesthetists 2012; 72: 29-31.
2. Pandit JJ, Cook TM, Jonker WR, O'Sullivan E. A national survey of anaesthetists (NAP5 baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in the UK. Anaesthesia 2013; 68: 343-53.
3. Pandit JJ, Cook TM. The Fifth National Audit Project: implications for hospital doctors. British Journal of Hospital Medicine 2013; 74: 306-7.
4. Pandit JJ, Andrade J, Bogod D, et al. The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: protocol, methods and analysis of data. Anaesthesia 2014; 69: 1078-88.
5. Sury MRJ, Palmer JHMacG, Cook TM, Pandit JJ. The state of UK anaesthesia: a survey of National Health Service activity in 2013. British Journal of Anaesthesia 2014; doi: 10.1093/bja/aeu292.
6. Brice DD, Hetherington RR, Utting JE. A simple study of awareness and dreaming during anaesthesia. British Journal of Anaesthesia 1970; 42: 535-42.
7. Avidan MS, Zhang L, Burnside BA, et al. Anesthesia awareness and the bispectral index. New England Journal of Medicine 2008; 358: 1097-108.
8. Avidan MS, Jacobsohn E, Glick D, et al.; BAG-RECALL Research Group. Prevention of intraoperative awareness in a high-risk surgical population. New England Journal of Medicine 2011; 365: 591-600.
9. Sandin RH, Enlund G, Samuelsson P, Lennmarken C. Awareness during anaesthesia: a prospective case study. Lancet 2000; 355: 707-11.
10. Myles PS, Leslie K, McNeil J, Forbes A, Chan MT. Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial. Lancet 2004; 363: 1757-63.
11. Sebel PS, Bowdle TA, Ghoneim MM, et al. The incidence of awareness during anesthesia: a multicenter United States study. Anesthesia and Analgesia 2004; 99: 833-9.
12. Wennervirta J, Ranta SO, Hynynen M. Awareness and recall in outpatient anesthesia. Anesthesia and Analgesia 2002; 95: 72-7.
13. Paech MJ, Scott KL, Clavisi O, Chua S, McDonnell N; The ANZA Trials Group. A prospective study of awareness and recall associated with general anaesthesia for Caesarean section. International Journal of Obstetric Anesthesia 2008; 17: 298-303.
14. Davidson AJ, Smith KR, Blusse Van Oud-Alblas HJ, et al. Awareness in children: a secondary analysis of five cohort studies. Anaesthesia 2011; 66: 446-54.
15. Ranta SO, Herranen P, Hynynen M. Patients' conscious recollections from cardiac anaesthesia. Journal of Cardiothoracic and Vascular Anesthesia 2002; 16: 426-30.
16. Pollard RJ, Coyle JP, Gilbert RL, Beck JE. Intraoperative awareness in a regional medical system: a review of 3 years' data. Anesthesiology 2007; 106: 269-74.
17. Leslie K. Awareness in a community-based anesthesia practice. Anesthesiology 2007; 107: 671-2.
18. Jonker WR, Hanumanthiah D, Ryan T, Cook TM, Pandit JJ, O'Sullivan EP. Who operates when, where and on whom? A survey of anaesthetic-surgical activity in the Republic of Ireland as denominator of NAP5. Anaesthesia 2014; 69: 961-8.
19. Jonker WR, Hanumanthiah D, Cook TM, Pandit JJ, O'Sullivan EP. A national survey (NAP5-Ireland baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in Ireland. Anaesthesia 2014; 69: 969-76.
20. Avidan MS, Mashour GA. The incidence of intra-operative awareness in the UK: under the rate or under the radar? Anaesthesia 2013; 68: 334-8.
21. Domino K, Posner K, Caplan R, Cheney F. Awareness during anesthesia: a closed claims analysis. Anesthesiology 1999; 90: 1053-61.
22. Mihai R, Scott S, Cook TM. Litigation related to inadequate anaesthesia: an analysis of claims against the NHS in England 1995-2007. Anaesthesia 2009; 64: 829-35.
23. Bogetz MS, Katz JA. Recall of surgery for major trauma. Anesthesiology 1984; 61: 6-9.
24. Ranta S, Ranta V, Aromaa U. The claims for compensation for awareness with recall during general anesthesia in Finland. Acta Anaesthesiologica Scandinavica 1997; 41: 356-9.
25. Aranake A, Gradwohl S, Ben-Abdallah A, et al. Increased risk of intraoperative awareness in patients with a history of awareness. Anesthesiology 2013; 119: 1275-83.
26. Ingrande J, Lemmens HJ. Dose adjustment of anaesthetics in the morbidly obese. British Journal of Anaesthesia 2010; 105 (Suppl 1): i16-23.
27. Ghoneim MM, Block RI, Haffarnan M, Mathews MJ. Awareness during anesthesia: risk factors, causes and sequelae: a review of reported cases in the literature. Anesthesia and Analgesia 2009; 108: 527-35.
28. Errando CL, Sigl JC, Robles M, et al. Awareness with recall during general anaesthesia: a prospective observational evaluation of 4001 patients. British Journal of Anaesthesia 2008; 101: 178-85.
29. Cook TM, Andrade J, Bogod D, et al. The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: patient experiences, human factors, consent and medicolegal issues. Anaesthesia 2014; 69: 1102-16.
30. Pandit JJ. Gambling with ethics? A statistical note on the Poisson (binomial) distribution. Anaesthesia 2008; 63: 1163-6.
31. Escallier KE, Nadelson MR, Zhou D, Avidan MS. Monitoring the brain: processed electroencephalogram and perioperative outcomes. Anaesthesia 2014; 69: 899-910.
32. Villafranca AJ, Arenson BG, Avidan MS, Glick D, Mashour GA, Jacobsohn E. Case report: volitional delay of self-reported outcomes: insights from a case of intraoperative awareness with explicit recall. Anesthesia and Analgesia 2013; 116: 365-7.
33. Ghoneim MM. Incidence of and risk factors for awareness during anaesthesia. Best Practice and Research in Clinical Anaesthesiology 2007; 21: 327-43.
34. Ghoneim MM, Block RI. Learning and consciousness during general anesthesia. Anesthesiology 1992; 76: 279-305.
35. O'Sullivan E, Laffey J, Pandit JJ. A rude awakening after our fourth 'NAP': lessons for airway management. Anaesthesia 2011; 66: 331-4.
36. Goodwin MW, Pandit JJ, Hames K, Popat M, Yentis SM. The effect of neuromuscular blockade on the efficiency of mask ventilation of the lungs. Anaesthesia 2003; 58: 60-3.
37. Sachdeva R, Kannan TR, Mendoca C, Patteril M. Evaluation of changes of tidal volume during mask ventilation following administration of neuromuscular blocking drugs. Anaesthesia 2014; 69: 826-31.
38. Patel A. Facemask ventilation before or after neuromuscular blocking drugs? Where are we now? Anaesthesia 2014; 69: 811-5.
39. Cook TM, Woodall N, Frerk C; Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. British Journal of Anaesthesia 2011; 106: 617-31.
40. Popat M, Mitchell V, Dravid R, Patel A, Swampillai C, Higgs A; Difficult Airway Society Extubation Guidelines Group. Difficult Airway Society Guidelines for the management of tracheal extubation. Anaesthesia 2012; 67: 318-40.
41. National Institute for Health and Care Excellence. NICE Diagnostics Guidance: Depth of anaesthesia monitors - Bispectral index (BIS), E-Entropy and Narcotrend Compact M. www.nice. org.uk/dg6. (accessed 30/06/2014).
42. Pandit JJ, Cook TM. National Institute for Clinical Excellence guidance on measuring depth of anaesthesia: limitations of EEG-based technology. British Journal of Anaesthesia 2014; 112: 385-6.
43. Russell IF. Fourteen fallacies about the isolated forearm technique, and its place in modern anaesthesia. Anaesthesia 2013; 68: 677-81.
44. Sleigh JW. The place of the isolated forearm technique in modern anaesthesia: yet to be defined. Anaesthesia 2013; 68: 681-3.
45. Pandit JJ. Isolated forearm - or isolated brain? Interpreting responses during anaesthesia - or 'dysanaesthesia'. Anaesthesia 2013; 68: 995-1000.
46. Pandit JJ. 'Acceptably aware' during general anaesthesia: 'dysanaesthesia' - the uncoupling of perception from sensory inputs. Consciousness and Cognition 2014; 27C: 194-212.